Collaborative Programs in HIV, STD and Hepatitis Prevention

Center for AIDS Prevention Studies (CAPS), and
San Quentin State Prison

NOTE: These studies have ended. Centerforce continues to run many of these programs.

San Quentin photo
San Quentin State Prison, California

Staff at Centerforce have been providing HIV Prevention Education since 1986 at San Quentin State Prison. Since 1992 we have been evaluating many of these programs in collaboration with the Center for AIDS Prevention Studies (CAPS), University of California, San Francisco. From 1986, these programs were based at the Marin AIDS Project; since 1997, they are based at Centerforce. These programs have expanded and evolved over the years, constantly changing to meet the needs of the incarcerated population and their families. The health programs now include information on HIV as well as other sexually transmitted infections, hepatitis, tuberculosis and other relevant health concerns.

Our advisory committee of inmate peer HIV educators helps us to develop new programs, modify existing strategies, and provide ongoing input to evaluate the effectiveness of our interventions. The success of these programs can be attributed to the commitment of all those involved: prison administrators, correctional officers, educators and counselors, university researchers, community-based service providers, the inmates themselves and family members.

A summary of these collaborative evaluation projects was published in a special issue of Health Education and Behavior.

Collaborative Programs in Prison HIV Prevention

Prevention Programs for Incoming and Current Inmates

reach one teach one logoAll men entering San Quentin are mandated to receive HIV education. Since 1991, we have been training inmates as peer HIV educators. Twice a year, volunteers are solicited to receive the comprehensive peer education training and then to work as peer educators within the prison. In the beginning all peer educators were themselves living with HIV; this has changed due to increased interest by uninfected men. Today, peer health educators conduct a variety of services within the prison including teaching the Health Orientation Class for incoming inmates, providing individual counseling for newly diagnosed inmates and helping releasing inmates develop individualized risk reduction plans. About 40 peer educators are trained each year.

Marin AIDS Project and CAPS collaborated to evaluate the HIV prevention orientation class for incoming inmates (Grinstead O, Faigeles B, Zack B. The effectiveness of peer HIV education for male inmates entering state prison. Journal of Health Education, 1997, Vol. 28, p. S31-S37). We have also collaborated to evaluate a pre-release risk reduction program conducted by inmate peer educators (Grinstead O, Zack B, Faigeles B, Grossman N, Blea L. Reducing post-release HIV risk among male prison inmates: a peer-led intervention. Criminal Justice and Behavior, 1999, Vol. 26, p. 453-465).

Programs for Inmates living with HIV

We conducted periodic focus groups to assess the service needs of inmates living with HIV, and to get feedback from them about primary prevention programs at the prison. As a result of these focus groups, we developed a two week, 8 session health promotion intervention for HIV+ inmates preparing to be released from prison. The interactive intervention sessions are conducted by members of the Centerforce staff and representatives of other community based agencies. The intervention sessions include such topics as self-esteem, health maintenance, community resources, stress management, substance use, legal issues and barriers to care after release as well as a resource fair to introduce community service providers. An evaluation was completed in 1998 and supports the effectiveness of the program in reducing risk behavior and increasing use of community services (Grinstead O, Zack B, Faigeles B. Reducing postrelease risk behavior among HIV seropositive prison inmates: the Health Promotion Program. AIDS Education and Prevention, Vol. 13, p.109-119).

Peer educators also provide individual support for inmates newly diagnosed in prison and for HIV+ inmates who have not been previously incarcerated.

Programs for Inmates Preparing for Release from Prison

San Quentin provides a prerelease program for men scheduled to leave the prison, but this intervention is not primarily focused on HIV prevention. Individual prerelease sessions provided by an HIV+ peer educator were designed specifically to prevent acquiring or transmitting HIV after release from prison. The intervention was a one-on-one session with an inmate peer educator in which each individual's HIV risk is assessed, an individualized risk reduction plan is created and referrals are given. Sessions were conducted within 2 weeks of release from prison. (CBJ article)

Project HIP HOP (Health In Prison, Health Out of Prison) will develop and test an intervention to prevent new HIV and STD infections among young men (18-29 years old) leaving prison. Project HIP HOP is funded by the Centers for Disease Control and Prevention. We collected qualitative interviews with in-prison service providers and qualitative and quantitative data with men pre-release and in the six months following release from prison. Based on this formative data, we developed an intervention and are currently in the process of testing the intervention in a randomized clinical trial.

Programs for Women with Incarcerated Partners

Inside Out photoWe have developed and are evaluating HOME (Health Options Means Empowerment), a peer-led HIV prevention intervention for women visiting their partners incarcerated at San Quentin. In our pilot study we found that women visitors perceive themselves to be in need of HIV education, support and community referral and they are willing to attend discussion groups on the topic of HIV and AIDS. We also found that many women were unaware of HIV risks specifically related to having an incarcerated partner.(Comfort M, Grinstead OA, Faigeles B, Zack B. Reducing HIV risk among women visiting their incarcerated male partners. Criminal Justice and Behavior, 2000, Vol 21, p. 57-71.) To address this issue, we created the video "Inside/Out: Real Stories of Men, Women and Life After Incarceration". As very little is known about this potentially high risk population, an additional goal of this project is to describe the population and their HIV prevention needs. Toward this goal, in addition to the intervention, we conducted cross-sectional surveys of women leaving the prison in August 1997 and August 1998.

Research findings

The Collaborative Programs in Prison HIV Prevention team has written two Science-to-Community reports:


Meet the staff of the Collaborative Programs in Prison HIV Prevention.